His and Her Health

Dear Dr Goldstein,

I leave in Sydney and I have had primary VVS (painful sex since first time).
for 10 years I was told by specialist that it was vaginism due to psychological trauma (easy answer...)
18 months ago I got a candida infection that was treated (following doctor's advice) with 2 months of antifungal cream and then after finally being diagnosed with VVS, another 3 months of systemic antifungal...
no need to say that it did not help!
I have now suffered from severe neurological pain (burning, stinging, cramping, tingling) that seems to come from the vestibule (V opening and skene's gland opening) but eventually spreads out. I wake up ok in the morning and it gets worse as I stand up and much worse when I sit.
I can use dilators though...


I have since had bartholinectomy and hymenectomy (Dr Reid), both tissues were chronically inflammed. I have then had PT, botox, TCA, Neurontin, with a bit of progress but I was still in pain.
I then found Prof Vancaillie who did pudendal nerve blocks, steroid injections, botox again, lidocaine injections...nothing helps.
I saw Dr Bautrant in France, my dopler was normal so he told me I needed a vesticulectomy because I do not have nerve entrapment neither nerve irritation due to muscle spasm (my pelvic floor is perfect by now and I have botox everywhere...), so he thinks the VVS triggers nerve irritation and neuralgia.

Coming back to Sydney, Prof Vancaillie is not so keen on the vestibulectomy.
I can't get anyone to tell me if I have VVS only (I clearly have red painful spots around Bartholin and skene's ducts) or generalised Vulvodynia + an old VVS.
To me it really seems that I have a primary VVS that got extremelly agravated by antifungal. I am in pain everyday and can't stand this anymore, I am only 33 years old!

I am really thinking of having the vestibulectomy and I would really appreciate to have your opinion on a case like mine (daily pain, not just sex). Also I am wondering if I should get my skene's glands removed since my Bartholins were inflammed and atrophied.

Thanks again for your care.

agnes

agnes,you have been through quite a series of treatments. Dr. Andrew Goldstein has become almost overwhelmed with new surgical patients. So much so that he has not been able to respond to posts on our forum.You might want to browse our website that Dr. Goldstein heads up. www.ourgyn.com